Hi all,
I am relating to Ana's posting below. Yes, I think we ARE all aware of the differences in the types of milk the baby gets throughout the feed, but with all the "instructions" and "measures", if not inches, (cms) if not grams and ozs. If not minutes at the breast, and add the foremilk hindmilk issue, sometimes yet again we forget to LOOK AT THE BABY!! One of the biggest problems I find is that HCPs are learning from the books but do not "Learn" to look at babies!!
I find moms hysterical because the baby's bottom lip is not covering 1.3 % (no that is not a REAL value) of the bottom of the areola!!!!! Really now, could anyone ever figure out how to "place" the baby so that could happen? Lips must be flanged we learn, so, what happens?
Moms are told to be sure that the baby's lips are flanged or it wont work, so the mom thinks she can pry her baby off the breast - just a wee bit to check the lips according to the practitioners instructions, and of course by the time THAT happens, well, the baby is only latched on to the nipple in the end because of the invasion of moms fingers!!
How many helpers are telling moms about this foremilk and hindmilk adding Yet another instruction that really has very little value IF WE SHOW MOMS THAT BABIES WILL BREASTFEED SUCCESSFULLY IF WE LET THEM. IF WE ARE IN TUNE WITH THEIR CUES, ACTIONS AND REACTIONS, THE MOM WILL SEE THAT THE BABY IS SATIATED. It just is not logical to expect moms to relate to this - so while I agree that it needs to be taught, it is more important that practitioners understand that the information is for THEM and not to drive moms crazy with worry because they will NEVer know exactly at what minute after commencement of breastfeeding that richer creamier milk will be delivered. Moms need to know that if they are patient, and watch their baby, if they allow them to finish on one side, take a break til they see signs of the baby's wanting to continue and offer the second side, then they will deliver all the kinds of milk that the baby needs. There is value in less fat milk as well, and the way we hear it today, it is as if it is water, which we know it is not. Of course, the slow weight gain or FTT is another story.
Ellen Shein, IBCLC, LLLI
Tel Aviv
This is really interesting that this information not to mention the numerous research pointing to the evidence of foremilk and hindmilk is not being taught correctly or at all? I know that breastmilk research changes and new information is brought to light from time to time. However you can't deny this, you can see the changes in milk with your own eyes. I am currently an LC student through UCSD and I can assure you all of our books talk about the composition changes in breastmilk including foremilk and hindmilk. Hindmilk, which is obtianed farther into the breastfeeding, is also the fat-rich cream layer seen in stored breastmilk. This cream layer can be especially calorie-dense with up to 28-30 calories more per once. This information is very important to know especially when dealing with a slow weight gaining baby. These nurses need to acknowledge this does exist. I suggest you take in some research that supports this and help educate them.
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